Smyth Elizabeth C, Cunningham David
Elizabeth C Smyth, David Cunningham, Department of Gastrointestinal Oncology, Royal Marsden Hospital, Sutton SM2 5PT, United Kingdom.
World J Gastrointest Oncol. 2014 Jun 15;6(6):145-55. doi: 10.4251/wjgo.v6.i6.145.
Oesophageal junctional adenocarcinoma is a challenging and increasingly common disease. Optimisation of pre-operative staging and consolidation of surgery in large volume centres have improved outcomes, however the preferred adjunctive treatment approach remains a matter of debate. This review examines the benefits of neoadjuvant, peri-operative, and post-operative chemotherapy and chemoradiotherapy in this setting in an attempt to reach an evidence based conclusion. Recent findings relating to the molecular characterisation of oesophagogastric cancer and their impact on therapeutics are explored, in addition to the potential benefits of fluoro-deoxyglucose positron emission tomography (FDG-PET) directed therapy. Finally, efforts to decrease the incidence of junctional adenocarcinoma using early intervention in Barrett's oesophagus are discussed, including the roles of screening, endoscopic mucosal resection, ablative therapies and chemoprevention.
食管交界腺癌是一种具有挑战性且日益常见的疾病。在大型中心优化术前分期和巩固手术已改善了治疗结果，然而首选的辅助治疗方法仍存在争议。本综述探讨了新辅助、围手术期和术后化疗及放化疗在此情况下的益处，试图得出基于证据的结论。除了氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）导向治疗的潜在益处外，还探讨了与食管胃癌分子特征及其对治疗影响相关的最新发现。最后，讨论了通过对巴雷特食管进行早期干预来降低交界腺癌发病率的努力，包括筛查、内镜黏膜切除术、消融治疗和化学预防的作用。
